Brucellosis in a patient with ochronosis – a rare case

Alkaptonuria, an inborn error of metabolism, is due to deficient activity of homogentisic acid dioxygenase(HGD) enzyme. It is known to commonly present as spondyloarthritis, especially in the third decade. We discuss the case of a 49-year-old lady, who had presented with fever, backache, and multiple joint pains for 8 months, aggravated since the past 1 week. This case highlights the need to consider an additional diagnosis especially when there is no clinical improvement and the fever persists. Having a high index of clinical suspicion for a treatable cause like brucellosis is favourable, as it can lead to a better outcome.